Improving Sleep Quality During the Transition to College

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Project Summary Sleep disruption during college presents a significant public health concern, with studies documenting clinically-significant sleep disruption in 40-60% of college students. Poor sleep contributes to rising anxiety, depression, and loneliness as well as declining positive affect, motivation, and sense of purpose faced by many students as they attempt to navigate a successful path through college. Disrupted sleep also negatively impacts physical health, in part through upregulating inflammatory processes that can have acute and more chronic effects on mental and physical health. In response, many colleges and universities have embarked on efforts to improve the sleep hygiene of their students. The challenge is to identify programs that can simultaneously improve sleep, be delivered at scale, and be easily completed by students. Mindfulness-based interventions (MBIs), including a six-week Mindful Awareness Practices (MAPs) intervention developed by our group, have been shown to improve sleep quality and associated psychosocial and biological outcomes among adults. MBIs are well-positioned between interventions targeting clinical insomnia (e.g., CBT-I) and mass-delivered sleep education programs, the latter of which have been rolled-out by many universities despite evidence of limited effectiveness. Only four published RCTs, however, have tested the effect of MBIs among college students and none targeted sleep as a primary outcome. To address this important public health problem, we propose to conduct a randomized controlled trial (RCT) of 240 first-year college students at a four-year university that serves an ethnically and economically diverse student population. Our two-arm, parallel group RCT will test the efficacy of the validated, group- based, six-week MAPs intervention vs. sleep education, an active time and attention matched control condition, for students who report poor sleep at this critical transition year. Effects will be assessed at post- intervention and at 3-, 9-, and 12-month follow-ups to assess persistence. Our project brings together a diverse team with expertise in sleep, mindfulness-based interventions, and youth development to pursue four aims: (1) determine effects of MAPs vs. sleep education on subjective and objective markers of sleep; (2) evaluate effects of MAPs vs. sleep education on negative and positive psychosocial symptoms associated with sleep disruption; (3) determine effects of MAPs vs. sleep education on inflammatory processes associated with sleep disruption and relevant for long-term health; and (4) explore potential sex and ethnic variations in intervention effects.